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2. Brentuximab vedotin-containing escalated BEACOPP variants for newly diagnosed advanced-stage classical Hodgkin lymphoma: follow-up analysis of a randomized phase II study from the German Hodgkin Study Group

Author

Damaschin, Carla, Goergen, Helen, Kreissl, Stefanie, Plütschow, Annette, Breywisch, Frank, Mathas, Stephan, Meissner, Julia, Sökler, Martin, Topp, Max S., Vucinic, Vladan, Zimmermann, Andreas, von Tresckow, Bastian, Fuchs, Michael, Engert, Andreas, Borchmann, Peter, and Eichenauer, Dennis A.

Published
2022
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3. PET-guided eBEACOPP treatment of advanced-stage Hodgkin lymphoma (HD18): follow-up analysis of an international, open-label, randomised, phase 3 trial

Author

Kreissl, Stefanie, Goergen, Helen, Buehnen, Ina, Kobe, Carsten, Moccia, Alden, Greil, Richard, Eichenauer, Dennis A, Zijlstra, Josée M, Markova, Jana, Meissner, Julia, Feuring-Buske, Michaela, Soekler, Martin, Beck, Hans-Joachim, Willenbacher, Wolfgang, Ludwig, Wolf-Dieter, Pabst, Thomas, Topp, Max S, Hitz, Felicitas, Bentz, Martin, Keller, Ulrich Bernd, Kühnhardt, Dagmar, Ostermann, Helmut, Hertenstein, Bernd, Aulitzky, Walter, Maschmeyer, Georg, Vieler, Tom, Eich, Hans, Baues, Christian, Stein, Harald, Fuchs, Michael, Diehl, Volker, Dietlein, Markus, Engert, Andreas, and Borchmann, Peter

Published
2021
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6. PET-guided treatment in patients with advanced-stage Hodgkin's lymphoma (HD18): final results of an open-label, international, randomised phase 3 trial by the German Hodgkin Study Group

Author

Borchmann, Peter, Goergen, Helen, Kobe, Carsten, Lohri, Andreas, Greil, Richard, Eichenauer, Dennis A, Zijlstra, Josée M, Markova, Jana, Meissner, Julia, Feuring-Buske, Michaela, Hüttmann, Andreas, Dierlamm, Judith, Soekler, Martin, Beck, Hans-Joachim, Willenbacher, Wolfgang, Ludwig, Wolf-Dieter, Pabst, Thomas, Topp, Max S, Hitz, Felicitas, Bentz, Martin, Keller, Ulrich Bernd, Kühnhardt, Dagmar, Ostermann, Helmut, Schmitz, Norbert, Hertenstein, Bernd, Aulitzky, Walter, Maschmeyer, Georg, Vieler, Tom, Eich, Hans, Baues, Christian, Stein, Harald, Fuchs, Michael, Kuhnert, Georg, Diehl, Volker, Dietlein, Markus, and Engert, Andreas

Published
2017
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8. Omission of dacarbazine or bleomycin, or both, from the ABVD regimen in treatment of early-stage favourable Hodgkin's lymphoma (GHSG HD13): an open-label, randomised, non-inferiority trial

Author

Behringer, Karolin, Goergen, Helen, Hitz, Felicitas, Zijlstra, Josée M, Greil, Richard, Markova, Jana, Sasse, Stephanie, Fuchs, Michael, Topp, Max S, Soekler, Martin, Mathas, Stephan, Meissner, Julia, Wilhelm, Martin, Koch, Peter, Lindemann, Hans-Walter, Schalk, Enrico, Semrau, Robert, Kriz, Jan, Vieler, Tom, Bentz, Martin, Lange, Elisabeth, Mahlberg, Rolf, Hassler, Andre, Vogelhuber, Martin, Hahn, Dennis, Mezger, Jörg, Krause, Stefan W, Skoetz, Nicole, Böll, Boris, von Tresckow, Bastian, Diehl, Volker, Hallek, Michael, Borchmann, Peter, Stein, Harald, Eich, Hans, and Engert, Andreas

Published
2015
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9. Impact of centralized diagnostic review on quality of initial staging in Hodgkin lymphoma: experience of the German Hodgkin Study Group

Author

Bröckelmann, Paul J., Goergen, Helen, Fuchs, Michael, Kriz, Jan, Semrau, Robert, Baues, Christian, Kobe, Carsten, Behringer, Karolin, Eichenauer, Dennis A., von Tresckow, Bastian, Klimm, Beate, Halbsguth, Teresa, Wongso, Diana, Plütschow, Annette, Haverkamp, Heinz, Dietlein, Markus, Eich, Hans T., Stein, Harald, Diehl, Volker, Borchmann, Peter, and Engert, Andreas

Published
2015
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10. 9p24.1 alterations and programmed cell death 1 ligand 1 expression in early stage unfavourable classical Hodgkin lymphoma: an analysis from the German Hodgkin Study Group NIVAHL trial.

Author

Gerhard‐Hartmann, Elena, Goergen, Helen, Bröckelmann, Paul J., Mottok, Anja, Steinmüller, Tabea, Grund, Johanna, Zamò, Alberto, Ben‐Neriah, Susana, Sasse, Stephanie, Borchmann, Sven, Fuchs, Michael, Borchmann, Peter, Reinke, Sarah, Engert, Andreas, Veldman, Johanna, Diepstra, Arjan, Klapper, Wolfram, and Rosenwald, Andreas

Subjects
*PROGRAMMED death-ligand 1, *HODGKIN'S disease, *MANTLE cell lymphoma, *MAJOR histocompatibility complex
Abstract

Summary: High programmed cell death 1 ligand 1 (PD‐L1) protein expression and copy number alterations (CNAs) of the corresponding genomic locus 9p24.1 in Hodgkin‐ and Reed–Sternberg cells (HRSC) have been shown to be associated with favourable response to anti‐PD‐1 checkpoint inhibition in relapsed/refractory (r/r) classical Hodgkin lymphoma (cHL). In the present study, we investigated baseline 9p24.1 status as well as PD‐L1 and major histocompatibility complex (MHC) class I and II protein expression in 82 biopsies from patients with early stage unfavourable cHL treated with anti‐PD‐1‐based first‐line treatment in the German Hodgkin Study Group (GHSG) NIVAHL trial (ClinicalTrials.gov Identifier: NCT03004833). All evaluated specimens showed 9p24.1 CNA in HRSC to some extent, but with high intratumoral heterogeneity and an overall smaller range of alterations than reported in advanced‐stage or r/r cHL. All but two cases (97%) showed PD‐L1 expression by the tumour cells in variable amounts. While MHC‐I was rarely expressed in >50% of HRSC, MHC‐II expression in >50% of HRSC was found more frequently. No obvious impact of 9p24.1 CNA or PD‐L1 and MHC‐I/II expression on early response to the highly effective anti‐PD‐1‐based NIVAHL first‐line treatment was observed. Further studies evaluating an expanded panel of potential biomarkers are needed to optimally stratify anti‐PD‐1 first‐line cHL treatment. [ABSTRACT FROM AUTHOR]

Published
2022
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11. Histopathological growth patterns in patients with advanced nodular lymphocyte‐predominant Hodgkin lymphoma treated within the randomized HD18 study: a report from the German Hodgkin Study Group.

Author

Eichenauer, Dennis A., Bühnen, Ina, Kreissl, Stefanie, Goergen, Helen, Fuchs, Michael, von Tresckow, Bastian, Rosenwald, Andreas, Klapper, Wolfram, Hansmann, Martin‐Leo, Möller, Peter, Bernd, Heinz‐Wolfram, Feller, Alfred C., Engert, Andreas, Borchmann, Peter, and Hartmann, Sylvia

Subjects
HODGKIN'S disease, POSITRON emission tomography, HISTOPATHOLOGY, PROGRESSION-free survival, OVERALL survival, NEUROECTODERMAL tumors
Abstract

Summary: We retrospectively investigated histopathological growth patterns in individuals with advanced nodular lymphocyte‐predominant Hodgkin lymphoma (NLPHL) treated within the randomized HD18 study. In all, 35/60 patients (58%) presented with atypical growth patterns. Patients with atypical growth patterns more often had stage IV disease (P = 0·0354) and splenic involvement (P = 0·0048) than patients with typical growth patterns; a positive positron emission tomography after two cycles of chemotherapy (PET‐2) tended to be more common (P = 0·1078). Five‐year progression‐free survival [hazard ratio (HR) = 0·86; 95% confidence interval (CI) = 0·49–1·47] and overall survival (HR = 0·85; 95% CI = 0·49–1·51) did not differ between the groups after study treatment with PET‐2‐guided escalated BEACOPP (bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, prednisone). Thus, advanced NLPHL is often associated with atypical growth patterns but their prognostic impact is compensated by PET‐2‐guided escalated BEACOPP. [ABSTRACT FROM AUTHOR]

Published
2022
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12. Non‐Hodgkin lymphoma after treatment for classical Hodgkin lymphoma: a report from the German Hodgkin Study Group.

Author

Eichenauer, Dennis A., Müller, Horst, Elger, Leonard, Goergen, Helen, Fuchs, Michael, Kreissl, Stefanie, Böll, Boris, Diehl, Volker, Tresckow, Bastian, Borchmann, Peter, and Engert, Andreas

Subjects
HODGKIN'S disease, LYMPHOMAS, THERAPEUTICS, RETROSPECTIVE studies
Abstract

Summary: Data on non‐Hodgkin lymphoma (NHL) after classical Hodgkin lymphoma (cHL) are scarce. We therefore performed a retrospective analysis comprising 11·841 cHL patients who had first‐line treatment within the randomized German Hodgkin Study Group (GHSG) HD7–HD15 studies. After a median follow‐up of 106 months, 175 patients (1·5%) had developed NHL. The median time to NHL was 44 months, the median age at NHL diagnosis was 54 years. The five‐year event‐free survival and overall survival estimates from the diagnosis of NHL were 36·9% and 44·2%, respectively. Thus, NHL after cHL is a rare event primarily affecting older individuals and often resulting in the patient´s death. [ABSTRACT FROM AUTHOR]

Published
2021
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14. Reduced-Intensity Chemotherapy in Patients With Advanced-Stage Hodgkin Lymphoma

Author

Engert, Andreas, Goergen, Helen, Markova, Jana, Pabst, Thomas, Meissner, Julia, Zijlstra, Josée M., Král, Zdenek, Eichenauer, Dennis A., Soekler, Martin, Greil, Richard, Kreissl, Stefanie, Scheuvens, Ruth, Eich, Hans, Kobe, Carsten, Dietlein, Markus, Stein, Harald, Fuchs, Michael, Diehl, Volker, and Borchmann, Peter

Subjects
long-term outcome, lcsh:RC633-647.5, Original Article, Advanced stages, lcsh:Diseases of the blood and blood-forming organs, Hodgkin lymphoma
Abstract

The international, randomized phase 3 HD15 trial established 6xeBEACOPP as standard therapy for patients with newly diagnosed advanced-stage Hodgkin lymphoma (HL) within the German Hodgkin Study Group (GHSG). We performed a follow-up analysis to assess long-term efficacy and safety of this approach. Between 2003 and 2008, 2182 patients aged 18 to 60 years were recruited and randomized in a 1:1:1 ratio between 8 or 6 cycles of eBEACOPP or 8 cycles of the dose-dense BEACOPP-14 regimen, each followed by 30 Gy radiotherapy in case of positron emission tomography (PET)-positive residual lesions ≥2.5 cm. The study aimed at demonstrating non-inferiority regarding efficacy of the 2 experimental arms on a significance level of 2.5% each. The intention-to-treat analysis comprised 2126 patients with a median follow-up of 102 months. Ten-year progression-free survival was 81% (97.5% CI 77–85) with 8xeBEACOPP, 84% (80–87) with 6xeBEACOPP, and 84% (80–87) with 8xBEACOPP-14; the non-inferiority margin of 1.51 for the hazard ratio (HR) could be excluded for both comparisons (6xeBEACOPP, HR = 0.7, 97.5% CI 0.5–1.0; 8xBEACOPP-14, HR = 0.9, 97.5% CI 0.7–1.2). Overall survival at 10 years was 88% (85–91), 90% (88–93), and 92% (89–94), respectively. A total of 142 second malignancies corresponding to 10-year cumulative incidences of 10%, 7%, and 7% and standardized incidence ratios of 4.3, 2.5, and 2.8 were reported for 8xeBEACOPP, 6xeBEACOPP, and 8xBEACOPP-14, respectively. This updated analysis of the HD15 trial thus confirms the efficacy and reports on the long-term safety of a shortened first-line chemotherapy consisting of 6xeBEACOPP followed by PET-guided radiotherapy in advanced-stage HL.

Published
2017

15. The interplay between cancer-related fatigue and functional health in Hodgkin lymphoma survivors.

Author

Stadtbaeumer, Nele, Müller, Horst, Goergen, Helen, Kreissl, Stefanie, Borchmann, Peter, and Mayer, Axel

Abstract

Objective: Cancer-related fatigue (CRF) is among the most distressing symptoms reported by cancer survivors as compromising their quality of life. This study investigates the complex interplay between CRF and functional health (FH) in survivors of Hodgkin lymphoma by using longitudinal data to clarify the etiology of CRF. Methods: Data from N = 3596 survivors (HD13-15) from the German Hodgkin Study Group was analyzed using bivariate latent curve models with structured residuals to model how the interplay between CRF and FH unfolds over time across and within individuals. CRF and FH were measured with the EORTC QLQ-C30. Assessed FH domains were physical, cognitive, emotional, social, and role functioning. Age at diagnosis, gender, country, baseline fatigue, and cancer stage were included as covariates. Results: The latent curve models with structured residuals had an adequate model fit (χ² = 416.63-548.28, df = 114, p < .001, root mean square error of approximation = .03, comparative fit index = .98-.99, Tucker-Lewis index = .97-.98). On the between-person level, CRF and all FH domains were strongly negatively correlated (r = -.72 to r = -.84). On the within-person level, earlier CRF (ρF = -.05 to ρF = -.12) and FH deviations (ρFH = -.05 to ρFH = -.13) negatively predicted subsequent deviations of the respective other variable. Time-specific within-person improvements in physical, cognitive, and emotional functioning reduced CRF more than vice versa, whereas the effect of CRF was stronger for social functioning. Role functioning had a balanced relation with CRF. Conclusions: This analysis reveals a complex reciprocal relation between CRF and FH with distinct between- and within-person effects. The results contribute to a better understanding of CRF in survivors of Hodgkin lymphoma and could inform the development of much-needed targeted interventions. [ABSTRACT FROM AUTHOR]

Published
2020
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17. Health-Related Quality of Life in Patients With Hodgkin Lymphoma: A Longitudinal Analysis of the German Hodgkin Study Group.

Author

Kreissl, Stefanie, Müller, Horst, Goergen, Helen, Meissner, Julia, Topp, Max, Sökler, Martin, Markova, Jana, Bernhard, Jürg, Greil, Richard, von Tresckow, Bastian, Behringer, Karolin, Rüffer, Jens-Ulrich, Flechtner, Hans-Henning, Möstl, Michaela, Fuchs, Michael, Engert, Andreas, Diehl, Volker, and Borchmann, Peter

Published
2020
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18. Efficacy of Nivolumab and AVD in Early-Stage Unfavorable Classic Hodgkin Lymphoma: The Randomized Phase 2 German Hodgkin Study Group NIVAHL Trial.

Author

Bröckelmann, Paul J., Goergen, Helen, Keller, Ulrich, Meissner, Julia, Ordemann, Rainer, Halbsguth, Teresa V., Sasse, Stephanie, Sökler, Martin, Kerkhoff, Andrea, Mathas, Stephan, Hüttmann, Andreas, Bormann, Matthias, Zimmermann, Andreas, Mettler, Jasmin, Fuchs, Michael, von Tresckow, Bastian, Baues, Christian, Rosenwald, Andreas, Klapper, Wolfram, and Kobe, Carsten

Published
2020
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21. Positron Emission Tomography–Guided Treatment in Early-Stage Favorable Hodgkin Lymphoma: Final Results of the International, Randomized Phase III HD16 Trial by the German Hodgkin Study Group.

Author

Fuchs, Michael, Goergen, Helen, Kobe, Carsten, Kuhnert, Georg, Lohri, Andreas, Greil, Richard, Sasse, Stephanie, Topp, Max S., Schäfer, Erhardt, Hertenstein, Bernd, Soekler, Martin, Vogelhuber, Martin, Zijlstra, Josée M., Keller, Ulrich Bernd, Krause, Stefan W., Wilhelm, Martin, Maschmeyer, Georg, Thiemer, Julia, Dührsen, Ulrich, and Meissner, Julia

Published
2019
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22. Efficacy and Safety of Nivolumab and AVD in Early-Stage Unfavorable Hodgkin Lymphoma: Extended Follow-up from the GHSG Phase II Nivahl Trial

Author

Bröckelmann, Paul J, Goergen, Helen, Keller, Ulrich, Meissner, Julia, Trautmann, Karolin, Halbsguth, Teresa V, Sasse, Stephanie, Sökler, Martin, Kerkhoff, Andrea, Mathas, Stephan, Hüttmann, Andreas, Bormann, Matthias, Zimmermann, Andreas, Fuchs, Michael, von Tresckow, Bastian, Baues, Christian, Rosenwald, Andreas, Klapper, Wolfram, Kobe, Carsten, Borchmann, Peter, and Engert, Andreas

Published
2020
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23. Survivors' perspectives on risks and benefits of Hodgkin lymphoma treatment: results of a survey by the German Hodgkin Study Group.

Author

Kreissl, Stefanie, Goergen, Helen, Müller, Horst, Bürkle, Carolin, Fuchs, Michael, Engert, Andreas, Behringer, Karolin, Borchmann, Peter, Meissner, Julia, and Mehnert, Anja

Subjects
*HODGKIN'S disease, *LYMPHOMA treatment, *THERAPEUTICS, *FOLLOW-up studies (Medicine)
Abstract

We performed a survey in Hodgkin lymphoma survivors to learn more about their perspectives on treatment risks and benefits. We sent questions to 1149 survivors from the GHSG's HD13-15 trials with (N = 249) or without (N =900) documented progression or relapse. The participation rate was 52% (N =581). After median follow-up of 106 months, 40% of relapse-free and over 60% of relapsed survivors were still worried about late effects and the possibility of relapse. Chemotherapy, largely independent of its intensity, had been a strain on 74% of relapse-free and 90% of relapsed survivors. Most physical, psychological, and socio-economic sequelae were more frequent among relapsed survivors (p <.05) and described as very burdensome. 74% of relapse-free and 61% of relapsed survivors considered primary cure from Hodgkin lymphoma as the most important aspect in the choice of treatment. Accordingly, primary optimal lymphoma control is of utmost importance from the patients' perspective. [ABSTRACT FROM AUTHOR]

Published
2019
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26. Outcome of Patients With Early-Stage Infradiaphragmatic Hodgkin Lymphoma: A Comprehensive Analysis From the German Hodgkin Study Group.

Author

Sasse, Stephanie, Goergen, Helen, Plütschow, Annette, Böll, Boris, Eichenauer, Dennis A., Fuchs, Michael, Behringer, Karolin, Zijlstra, Joseé M., Greil, Richard, Markova, Jana, Topp, Max S., Meissner, Julia, Neubauer, Andreas, Baues, Christian, Engert, Andreas, Borchmann, Peter, von Tresckow, Bastian, Plütschow, Annette, Böll, Boris, and Zijlstra, Joseé M

Published
2018
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28. Early Interim PET in Patients with Advanced-Stage Hodgkin's Lymphoma Treated within the Phase 3 GHSG HD18 Study

Author

Borchmann, Peter, Goergen, Helen, Kobe, Carsten, Lohri, Andreas, Greil, Richard, Eichenauer, Dennis A., Zijlstra, Josée M, Markova, Jana, Meissner, Julia, Feuring-Buske, Michaela, Hüttmann, Andreas, Dierlamm, Judith, Sökler, Martin, Krause, Stefan W., Eich, Hans, Baues, Christian, Kreissl, Stefanie, Fuchs, Michael, Dietlein, Markus, and Engert, Andreas

Published
2017
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31. Cancer-Related Fatigue in Patients With and Survivors of Hodgkin Lymphoma: The Impact on Treatment Outcome and Social Reintegration.

Author

Behringer, Karolin, Goergen, Helen, Müller, Horst, Thielen, Indra, Brillant, Corinne, Kreissl, Stefanie, Halbsguth, Teresa Veronika, Meissner, Julia, Greil, Richard, Moosmann, Peter, Shonukan, Oluwatoyin, Rueffer, Jens Ulrich, Flechtner, Hans-Henning, Fuchs, Michael, Diehl, Volker, Engert, Andreas, and Borchmann, Peter

Published
2016
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36. Brentuximab vedotin (SGN-35) in patients with transplant-naive relapsed/refractory Hodgkin lymphoma.

Author

Sasse, Stephanie, Rothe, Achim, Goergen, Helen, Eichenauer, Dennis A., Lohri, Andreas, Kreher, Stephan, Jäger, Ulrich, Bangard, Christopher, Kuhnert, Georg, Böll, Boris, von Tresckow, Bastian, and Engert, Andreas

Subjects
HEALTH outcome assessment, CANCER relapse, DISEASE relapse, STEM cell transplantation, COMPLICATIONS from organ transplantation, HODGKIN'S disease treatment, SALVAGE therapy, PATIENTS
Abstract

Only limited data are available on the role of brentuximab vedotin (SGN-35) in transplant-naive relapsed or refractory patients with Hodgkin lymphoma (HL). We thus retrospectively analyzed 14 patients with primary refractory or relapsed HL who were treated with brentuximab vedotin as single agent in a named patient program, who had not received prior high-dose chemotherapy (HDCT) and autologous stem cell transplant (ASCT) due to refractory disease ( n = 9), comorbidity ( n = 4) and unknown reasons ( n = 1). Brentuximab vedotin resulted in an overall response rate of 71% (10/14) with five complete responses (CRs). Five of those patients with refractory disease and four patients with relevant comorbidity responded. Consolidating ASCT ( n = 4) or allogeneic SCT ( n = 1) was performed in five patients. Median progression-free survival (PFS) was 9 months and the median overall survival (OS) was not reached. These data indicate the therapeutic efficacy of brentuximab vedotin in chemotherapy-refractory transplant-naive patients with HL. [ABSTRACT FROM AUTHOR]

Published
2013
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38. Gonadal Function and Fertility in Survivors After Hodgkin Lymphoma Treatment Wiithin the German Hodgkin Study Group HD13 to HD15 Trials.

Author

Behringer, Karolin, Mueller, Horst, Goergen, Helen, Thielen, Indra, Eibl, Angelika Diana, Stumpf, Volker, Wessels, Carsten, Wiehlpütz, Martin, Rosenbrock, Johannes, Halbsguth, Teresa, Reiners, Katrin S., Schober, Thomas, Renno, Jorg H., von Wolff, Michael, van der Ven, Katrin, Kuehr, Marietta, Fuchs, Michael, Diehl, Volker, Engert, Andreas, and Borchmann, Peter

Published
2013
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39. Treatment of Stage I-II A Non-Bulky Hodgkin's Lymphoma (HL): An Individual Patient-Data Comparison of German Hodgkin Study Group (GHSG) HD10 and HD11 Combined-Modality Therapy (CMT) and NCIC Clinical Trials Group (NCIC CTG) HD.6 ABVD Alone

Author

Hay, Annette E., Klimm, Beate, Chen, Bingshu E., Goergen, Helen, Shepherd, Lois E., Fuchs, Michael, Gospodarowicz, Mary, Borchmann, Peter, Connors, Joseph M., Markova, Jana, Crump, Michael, Lohri, Andreas, Winter, Jane N., Dörken, Bernd, Pearcey, Robert G., Diehl, Volker, Horning, Sandra J., Eich, Hans Theodor, Engert, Andreas, and Meyer, Ralph M.

Published
2012
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43. PET-guided Treatment in Patients with Advanced-stage Hodgkin's Lymphoma (HD18): Final Results of An Open-label, International, Randomised Phase 3 Trial by the German Hodgkin Study Group.

Author

Borchmann, Peter, Goergen, Helen, Kobe, Carsten, Lohri, Andreas, Greil, Richard, Eichenauer, Dennis A., Zijlstra, Josée M., Markova, Jana, Meissner, Julia, Feuring-Buske, Michaela, Hüttmann, Andreas, Dierlamm, Judith, Soekler, Martin, Beck, Hans-Joachim, Willenbacher, Wolfgang, Ludwig, Wolf-Dieter, Pabst, Thomas, Topp, Max S., Hitz, Felicitas, and Bentz, Martin

Published
2018

44. Early Response to First-Line Anti-PD-1 Treatment in Hodgkin Lymphoma: A PET-Based Analysis from the Prospective, Randomized Phase II NIVAHL Trial.

Author

Voltin CA, Mettler J, van Heek L, Goergen H, Müller H, Baues C, Keller U, Meissner J, Trautmann-Grill K, Kerkhoff A, Fuchs M, Sasse S, von Tresckow B, Dietlein M, Borchmann P, Engert A, Kobe C, and Bröckelmann PJ

Subjects
Adult, Dacarbazine administration & dosage, Doxorubicin administration & dosage, Female, Hodgkin Disease metabolism, Humans, Immune Checkpoint Inhibitors administration & dosage, Male, Middle Aged, Nivolumab administration & dosage, Outcome Assessment, Health Care methods, Outcome Assessment, Health Care statistics & numerical data, Prospective Studies, Survival Analysis, Vinblastine administration & dosage, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Hodgkin Disease diagnostic imaging, Hodgkin Disease drug therapy, Positron-Emission Tomography methods
Abstract

Purpose: A primary analysis of the ongoing NIVAHL trial demonstrated unexpectedly high interim complete response rates to nivolumab-based first-line treatment in early-stage unfavorable Hodgkin lymphoma. However, biomarkers such as metabolic tumor volume (MTV) or total lesion glycolysis (TLG) and their change under treatment (ΔMTV and ΔTLG), measured on PET, might provide additional relevant information for response assessment in this setting. Hence, the current analysis aimed to investigate early response to checkpoint inhibitor therapy beyond conventional criteria., Patients and Methods: NIVAHL is a prospective, randomized phase II trial that recruited between April 2017 and October 2018. Patients in arms A and B were assessed for early treatment response after two courses of doxorubicin, vinblastine, and dacarbazine with two concomitant nivolumab infusions per cycle (2 × N-AVD) and 4 × nivolumab, respectively. In the current analysis, we included all 59 individuals with PET images available to the central review panel for quantitative analysis before April 30, 2019., Results: At interim restaging, we determined a mean ΔMTV and ΔTLG of -99.8% each in arm A after 2 × N-AVD, compared with -91.4% and -91.9%, respectively, for treatment group B undergoing 4 × nivolumab. This high decrease in MTV and TLG was observed regardless of the initial lymphoma burden., Conclusions: Our study showed that nivolumab-based first-line treatment leads to rapid, near-complete reduction of tumor metabolism in early-stage unfavorable Hodgkin lymphoma. Thus, PET-derived biomarkers might allow reduction or even omission of chemotherapy and radiotherapy. Furthermore, MTV and TLG could be also used to optimize immune checkpoint-targeting treatments in other cancers., (©2020 American Association for Cancer Research.)

Published
2021
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46. Suicide in European Hodgkin Lymphoma Patients.

Author

Kim AI, Goergen H, Engert A, LaCasce AS, Maranda L, Barton B, and Borchmann S

Abstract

The purpose of this study was to determine whether there is an increased risk of suicide in European Hodgkin Lymphoma (HL) patients compared to the general European population. European HL patients enrolled in the German Hodgkin Study Group (GHSG) HD7 through HD15 studies were analyzed and standardized mortality ratio (SMR) was calculated using suicide mortality rates for the general European population. Case-control analysis was performed to identify characteristics associated with risk of death by suicide. Among 12,202 European HL patients observed for 94,972 person-years, 19 suicides (17 males and 2 females) were identified resulting in a SMR 1.63 (95% CI: 1.01-2.50, p = 0.046). The only characteristic associated with a statistically significant increased risk of suicide was male sex with an odds ratio (OR) 8.42 (95% CI = 1.04-67.85; p = 0.046) on multivariate analysis. These findings were confirmed in an independently analyzed Surveillance, Epidemiology, and End Results Program (SEER) validation dataset. European HL patients have a significantly increased incidence of suicide compared to the general European population. Male HL patients have a greater than 8-fold increased risk of suicide compared to female HL patients. Further study of social risk factors associated with an increased risk of suicide in HL patients is needed., (Copyright © 2019 the Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the European Hematology Association.)

Published
2019
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